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Cancer survivorship: Cardiovascular and respiratory issues

Authors
Bonnie Ky, MD, MSCE
Lavanya Kondapalli, MD
Daniel J Lenihan, MD
Section Editor
Patricia A Ganz, MD
Deputy Editor
Sadhna R Vora, MD

INTRODUCTION

With the recent success of modern cancer therapy, cancer can be curable, and in cases where cure cannot be achieved, it can be treated as a chronic disease. As a result, there are now more than 13 million cancer survivors in the US alone [1] and close to 30 million worldwide [2]. Given the growing population of patients once treated (or continuing treatment) for cancer, the medical community must learn how to best minimize the complications of cancer treatment.

The cardiovascular effects of cancer therapy are critically important to the overall health of cancer survivors [3] as a growing population recognized to have an increased incidence of hypertension, valvular disease, cardiomyopathy and heart failure, and pulmonary disease compared with the general population [4]. Because these conditions can result in a high degree of morbidity and mortality, understanding how to improve the prevention, recognition, and treatment of cardiovascular and pulmonary disease is an important medical priority.

This section will focus on the long-term cardiovascular complications encountered in cancer survivorship, and will also cover respiratory issues related to cancer therapy. Since there are a myriad of possible complications of cancer therapy [5], this section will summarize the most important and common conditions related to these systems. In each subsection, the diagnosis, treatment, and prognosis will be highlighted, if known, and areas where improvements in understanding are needed will be outlined. Finally, practical recommendations will be made for certain principles that may help guide the optimal treatment of cardiovascular effects in cancer survivors.

For readers who desire a broader overview of cancer survivorship, a separate topic that discusses these issues is available. (See "Overview of cancer survivorship care for primary care and oncology providers".)

ATHEROSCLEROSIS

Secondary to RT — It is well-established that radiation therapy (RT) is associated with an increased risk of coronary [6] and carotid artery disease [7-9]. This is believed to be secondary to damage to the microvasculature, which results in endothelial dysfunction, inflammation, oxidative stress, and accelerated atherosclerosis.

                    

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Literature review current through: Nov 2016. | This topic last updated: Tue Feb 16 00:00:00 GMT+00:00 2016.
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